Article Critique: Implementing and sustaining transformational change in health care
The article sheds light on the significance of clinical process redesign in the delivery of health care care services in emergency departments as well as elective surgery programs in New South Wales with physical benefits for patients and staff. According to the article, the principles that are present in the clinical process are not new because other industries have applied for an extended period. The experience of clinical process redesign has paved the way for other lessons in making successful implementations in maintaining the process in the health industry. The author provides that the primary elements for success when it comes to leadership by executives, clinical leadership, a look into the journey of patients, problems solving based on teams, access to data, zealous target, and process for maintaining improvement.
The author emphasizes the fact that visible involvement in leadership is essential in management (Katherine et al., 2008). As such the senior management needs to be keen on the standard they set for service delivery, to change the process. Therefore, the administration needs to engage and challenge staff with goals that go beyond their present ability, set the platform for workable solutions, ensure that strategies are with the set budgets and deadlines, performance is up to par, and reward success. Staff members should see that the program is of importance to the chief executive officer.
The authors cite that, for one to face challenges like resistance or failure of a set project, the leader should be in a position to press on. The articles have revealed that an executive team directly involved with the hospital level is essential. For instance, Flinders Medical Centre found it valuable to have the seniors and executives working together in following up on the patients’ journey in clinical work (Katherine et al., 2008). As a result, it has helped to incorporate redesign as part of the staff does every day. The paper gives examples of the New South Wales redesign of having regular visits that include the directors working with the team. As a result, the staff has the right motivation and they are giving the process redesign a high priority.
For a long time, the Flinder medical center has been in operation since 2004 and November 2003 (Katherine et al., 2008). In regards to the local needs and conditions, there are different ways in which the projects take place. The universal principles for successful implementation as well as sustainability are other programs in similar forums, like the National Health Service in the United Kingdom.
Another point that the article highlights are the need for engaging clinical leader. According to the authors, the clinical process is more of a system of care delivery as opposed to changing clinical practice. As such, clinical leadership should be a matter of emphasis. The significance of engaging clinicians is to encourage management to commit in advance to use the solutions suggested and designed by the staff. It is important to note that staff members like to feel part of the change process by having their solutions implemented.
On the contrary, not implementing the solutions will create tension due to cynism and other relationship problems. Therefore, to commit to the implementation, it is best that the solutions identified by the staff become part of the development. The management should set the standards as per the resources available. Providing solutions that are not within the cost benefits, the staff will need to justify the expense and ensure that there are ways to achieve the set goals. Solutions that are within the current resources should start as soon as possible and changed if they do not serve their purpose.
According to the article, it is advisable that there is increased safety in the outcome of the redesign to attract clinicians. That is one step to ensuring that the journey or process is more efficient for the staff. Most organizations operate on a costs basis; if something is not making a profit, it becomes a liability. Clinicians should commit to simplifying the clinical challenges and eliminating wastage of time and costs. The involvement of clinicians in checking the problems and creating the solutions should be in a manner that covers their needs are busy professionals with little or no free time. Take, for instance, meeting for short periods when the time is most available.
Lastly, the authors also cite that redesign is most efficient if the workgroup has people who are ready and willing to work and has those with redesign experience (Katherine et al., 2008). The workbook should have ample time as well as resources to collect and analyze data, create interventions, and plan for the implementation process as well as its impact. The workgroup must be given the time and the resources to gather and analyze the data, develop interventions, then plan the implementation and monitor its effects. For this to happen the article asserts that there should be a focus on the clinical redesign process for the patients belonging to groups with the same services delivery needs.
The groupings are significantly more important that disease-based classification. The significance of the groups is similarly of the journey of the patients. For example, there are outpatients, frail patients with multiple conditions and other comorbid issues, fit patients who can maneuver daily (Katherine et al., 2008). In the whole process, the most important thing is to understand the demand of patients and creating a standard program that will help them have an efficient redesigning process. Therefore, the steps in the journey are easy to understand by the staff and the patients. Thus, the general procedures are vibrant designs and less prone to mistakes because they are easy to comprehend.
A look into the article reveals that researchers have discussed an important topic in health care. In the era of streamlining processes to ease communication and providing better services in health care, the article offers a platform for more research in redesigning (Katherine et al., 2008). This programs will be useful not only to the clinical professional, but also the patients. The study incorporates the fact that any change process requires flawless communication with the staff members. Workers like to believe that they are productive and part of the change. Therefore, the best results for the redesigning process is to have leaders working together with other staff by creating open communication channels.
It is significant that the research article mentions the need to implement the suggested change in the redesigning process (Katherine et al., 2008). However, the suggested changes should be in line with the organization’s set goals as well as cost. If the change will cost the organization more than what is within the budget, then it is not worth the implementation. It is notable that the article advices on the essentiality of communicating this aspect to the team members for them to understand that they should try another method or find ways to compensate. It is critical that the management can create a flow of ideas and give feedback to establish trust between the seniors and other staff (Katherine et al., 2008). The article sheds light on these aspects by emphasizing on keeping communication open in implementing redesigning.
The article has highlighted significant issues in the redesign process. However, there is a limitation advising to collect data. A good approach for that section would provide examples of similar works for one to get a full understanding of the process (Mattenson et al., 2016). The article seems to give a general idea which is problematic in regards to the scope of the project. The fact that the topic touches a sensitive are-healthcare, it would be best to give full accounts to avoid creating assumptions. While the studies mentioned that it allowed for future research into the topic, such details should have highlighted on data.
Another limitation of the article is that there are no recommendation or proper citation for reference. As such, for academic and scientific research, one needs to find more information form secondary materials (Mattenson et al., 2016). This leaves the article as an assumption as opposed to a research paper. Therefore, there should be additional information focused on providing sources and also increasing the number of examples. The best approach for this type of study is to employ quantitative design because of the scope of the research. The method would help to provide an insight into how redesigning would work with different groups, costs, deadlines, and such.
To sum it up, while the study has merit in terms of research, there is the need to identify with the fact that the power of the study depends on obtaining a broader set of data (Mattenson et al., 2016). Another area that needs improvement is to create a quantitative analysis that will help collect numeric data, which will assist in implementing the research or putting the study up for a recommendation or further studies. Another demerit of the article is that it lacks sensitivity when it comes to the scoop of the study. Depending on the area of research, and the magnitude of the course, the investigation ought to have evaluated the potential meaningfulness of the study. Away from that, the study has created a platform for academic, individual and scholarly research when it comes to redesigning. The authors have shared encouraging area of interest in implementing and creating sustainable change in healthcare. Because organizations go through constant change, the study comes in handy in educating the healthcare sector on how to carry out the process. The authors offer to redesign as one of the ways to implement change as well as shed light on the process that clinical professionals should learn. However, the study does not remind us of the need to understand the difficulty of the change process. Despite emphasizing on the need for change, it does not adequately provide for the preparation of rigidity. Therefore, there need to be more redesigning studies that will give a clear description of the process, identify the need for a more significant area of research and encouraging scholarly research. Without this, it is difficult to establish the potential of the study in healthcare processes.
Katherine M McGrath, Denise M Bennett, David I Ben-Tovim, Steven C Boyages, Nigel J
Lyons and Tony J O’Connell. (2008). Implementing and sustaining transformational change in health care: lessons learnt about clinical process redesign. Medical Journal of Australia. https://www.mja.com.au/journal/2008/188/6/implementing-and-sustaining-transformational-change-health-care-lessons-learnt
Mårtensson, P., Fors, U., Wallin, S. B., Zander, U., & Nilsson, G. H. (2016). Evaluating
research: A multidisciplinary approach to assessing research practice and quality. Research Policy, 45(3), 593-603.
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